针药并用治疗糖尿病肾病脾肾气虚兼痰瘀证临床研究

目的:观察针药并用对糖尿病肾病脾肾气虚挟痰瘀证患者氧化应激水平的影响。方法:116例糖尿病肾病脾肾气虚挟痰瘀证患者按照随机数字表法分为对照组和观察组各58例。对照组患者给予厄贝沙坦片口服,观察组给予针药综合疗法,1周为1个疗程,两组均连续治疗8个疗程。比较两组患者临床疗效,观察患者治疗前后血糖、血脂及肾功能各指标水平变化,检测治疗前后患者血清超氧化物歧化酶(superoxide dismutase,SOD)、晚期糖基化终末产物(advanced glycosylation end products,AGE)、晚期氧化蛋白产物(advanced oxidation protein products,AOPP)、丙二醛(malondialdehyde,MDA)水平变化。结果:观察组的有效率为91.3%高于对照组的75.9%(χ2=5.098,P0.05)。治疗后,观察组患者的血糖、血脂及肾功能改善优于对照组,其各指标水平显著低于对照组患者(P0.05);观察组患者经治疗后SOD活性显著高于对照组患者,而AGE、AOPP、MDA水平则显著低于对照组患者(P0.05)。结论:针药并用治疗糖尿病肾病患者疗效肯定,利于改善患者的糖脂代谢,提高肾功能,其机制与增强SOD活性、清除AGE、AOPP、MDA以减轻患者的氧化应激损伤有关。

Clinical Research on Spleen-Kidney Qi Deficiency with Phlegm and Blood Stasis Syndrome of Diabetic Nephropathy Patients with Acupuncture and Drugs

Objective:To observe the influence on oxidative stress levels for treating spleen-kidney Qi deficiency with phlegm and blood stasis syndrome of diabetic nephropathy patients with acupuncture and drugs.Methods:116 cases were randomly divided into the control group of 58 cases and the observation group of 58 cases.Patients in the control group were treated with irbesartan tablets,while patients in the observation group were given acupuncture and drugs,one week for a course,8 courses for treatment.The paper was focus on comparing the effectiveness,observing the change of blood sugar,blood fat and kidney function,and monitoring the levels change of SOD,AGE,AOPP and MDA.Results:The efficiency for patients in the observation group was 91.3 ％,which was higher than that of the effective rate of control group 75.9％ (x2 =5.098,P ＜ 0.05).The improvement of blood sugar,blood fat and kidney function for patients in the observation group were better than those of the control group,and the index levels were lower than those of the control group (P ＜ 0.05).The level of SOD for patients in the observation group was higher than that of the control group after treatment,while the levels of AGE,AOPP and MDA for patients in the observation group were lower than those of the control group after treatment(P ＜0.05).Conclusion:Acupuncture and drugs in the treatment of diabetic nephropathy has definite curative effect.It is good to improve the patients' glucolipid metabolism and renal function.The mechanism may be associated with reducing oxidative stress injury to protect the kidney by enhancing the SOD activity and removing the AGE,AOPP and MDA roles.